Equal kinematics between central anatomic single-bundle and double-bundle anterior cruciate ligament reconstructions

Area of Science:

• Orthopedic surgery
• Biomechanics
• Sports medicine

Background:

• Anterior cruciate ligament (ACL) injuries are common, significantly impacting knee joint stability.
• Restoring normal knee kinematics after ACL reconstruction is crucial for patient function.
• Comparing single-bundle and double-bundle reconstruction techniques is essential for optimizing surgical outcomes.

Purpose of the Study:

• To compare the knee kinematics of single-bundle versus double-bundle anterior cruciate ligament (ACL) reconstruction.
• To evaluate the effectiveness of these techniques using hamstring grafts and anatomic tunnel placement.
• To assess the restoration of anterior tibial translation and rotation under various load conditions.

Main Methods:

• Utilized a computer navigation system to measure anterior tibial translation and rotation in cadaveric knees.
• Applied anterior force, internal/external torque, and combined loads at 30 and 60 degrees of flexion.
• Compared kinematics with intact ACL, transected ACL, and after single-bundle or double-bundle reconstruction.

Main Results:

• ACL transection significantly increased anterior tibial translation at 30 and 60 degrees of flexion under specific loads.
• Both single-bundle and double-bundle reconstructions successfully restored normal knee kinematics.
• No significant changes in maximum internal or external rotation were observed after ACL injury.

Conclusions:

• Central anatomic single-bundle and double-bundle ACL reconstructions effectively restore knee kinematics.
• Both techniques provide comparable restoration of anterior tibial translation under anterior and rotational loads.
• Single- and double-bundle ACL reconstructions are equally effective in stabilizing the knee post-injury.